Paracentesis needle or trocar.



H P. HILL. PARACENTESIS NEEDLE 0R TROCAR.

APPLICATION FILED APR. 10, 1917.

Patented Dec. 4f,

Alim/Mey nur u aras naar ernten.

H JPHTLIP HILL, 0F SAN ANTONIO, TEXAS, ASSIGNOR 0F ONE-HALF T0 A. D.HASKELJL, 0F ALEXANDBTA, MINNESOTA.

Specification of Letters Patent.

Patented Dec.. a, 191% ApplicatiOil led April 10, 191?. Serial No.161,043.

To all whom it may concern:

Be it known that l, H PHILrP HILL, a citizen of the United States,residing at San Antonio, in the county of Bexar and State of Texas, haveinvented a new and useful Paracentesis Needle or Trocar, of which thefollowing is a specification.

The present invention relates to surgical instruments, and hasparticular reference to an improved needle or trocar tor use inparacentesis, `in withdrawing water in cases of dropsy, in drainingseptic matter from internal parts, and for use in eases where it isdesired to drain any internal part, or to inject fluid into the cavity.

It is an object of the present invention to provide an instrument ofthis nature with a hollow or tubular perforating rod or stylet, adaptedfor connection with a flexible tube or pipe to drain an internal part,after puncturing the wall thereof, and to provide a device with acannula, or outer tube adapt ed to be forced through the pnnctured wallto cover the piercing end of the stylet, and protect the internal partfrom further puncturing or injury.

The invention has for another object to provide this improved instrumentwith a locking means for holding the cannula seeurely in eitherretracted or extended position, and to insure the binding of the same inits closed or retracted position.

Further, the invention aims at the provision of an instrument capable ofaccomplishing the above noted results, and which at the same time may bereadily cleansed and readily cleared of all matter which tends to` clogup the tubes or openings therein, so that the device may be kept clear,without withdrawin the same from the internal part, or disturbing any ofthe adjustments which are made to position the instrument.

ther objects and advantages of this invention will be brought out in thefollowing description of the present preferred embodiment, which isshown in the accompanyingr drawing, wherein:

igure 1 is a side elevation of the irnproved instrument closed and readyto be packed away, or conveniently carried.

Fig. 2 is a longitudinal central section,

through the same.

Fig. 3 is a side elevation, partly in section" of the instrumentadjusted in the position which it assumes subsequent to its insertionthrough the wall of the internal part, the view showing the penetratingpoint protected by the inner end of the cannula.

Fig. 4 is alongitudinal central section taken through the same at rightangles to the showing in Fig. 3.

Fig. 5 is a detail perspective shank and head of the stylet.

Fig. 6 is a detail perspective view of the socket sleeve for receivinthe shank, the view showing the adjusting and locking slots for securingthe parts of the instrument in -their different positions.

Fig. 7 is a detail enlarged view of the end of the instrument showingthe view of the lower adjustment of the piercing point, when it is to beapplied to the wall of the internal part.

Referring to this drawing, 10 designates a styletl in the form of a tubeprovided upon its inner or lower end with a piercing point 11 formed bycutting ott the tube abruptly and diagonally to the longitudinal axis ofthe tube 10, so that the sharpened extremity of the point 11 is disposedat one side of the stylet 10.

The upper or outer end of this stylet tube 10 is secured in one end of atubular shank 12, which terminates at its opposite or outer end in ahead 13, forming a nipple which is rounded, or otherwise given suitableform for receiving thereover and holding the end of a-rubber, or otherflexible tubing. The head or nipple 13 and shank 12 are providedtherethrough with an opening which communicates with the interior of thestylet 10, so as to provide an uninterrupted passage from the stylet 10directly through the device, and through the tube 14, as shown toadvantage in Fig. 4. The head 13 terminates at its inner end in anoutstanding an nular shoulder 15 surrounding the outer end of the shank12 and constituting a stop flange for a purpose which will hereinafterappear.

Mounted to slide upon the stylet 10 is a cannula 16 in the form of atube, which is of less length than the stylet 10, and which is providedupon its lower end, or inner end, with a reduced edge 17 formed bytapering or beveling the outer wall of the tube 16, as shown toadvantage in the drawings. This tube 16 is adapted to be slid inwardlyupon the stylet 10 until the edge 17 projects beyond the piercing point11 to protect the point, and close it in from contact With partssurrounding the point. For sliding this tube or cannula upon the forsecuring the same in either retracted position, or extended position,the cannula 16.is secured at its outer end upon a socket sleeve 18,adapted to fit snugly over the shank 12, and to move outwardly towardthe stop l5, when it is desired to retract the edge 17. The shank 12carries a stud '19 projecting laterally from the inner end of the shankand engaging in a longitudinal slot 20, formed in one side of the sleeve18. The sleeve 18 is also provided, at its opposite ends withcircumferential slots 21 and 22, formed respectively at the inner andouter ends of the sleeve 18, and which communicate with the oppositeends of the 1ongitudinal slot 2 he pin or stud 19 is adapted to move inthe longitudinal slot 20 and to move into the laterally extendingcircurnferential slots 21 and 22 upon the partial rotation and thesliding movement of the sleeve 18. The outer end of the sleeve 18 isreinforced by an outturned flange or ring 23 adapted to abut against theshoulder 15, when the cannula is retracted. The flange or ring 23 has inits inner wall a middle of the slot 22. he notch is out of alinementwith the longitudinal slot 20 so that it will be impossible to Withdrawthe stylet from the cannula by a direct pull thereon, while the pin 19is in the slot 20.

he cannula must first be rotated, bringing the pin into the center ofthe slot 22 hefore the cannula can be separated therefrom. Thisarrangement of the notch, however,

oes not prevent the locking of the stylet and cannula together when thepin is in the extreme inner end of the slot 22.

For the purpose of admitting the ready cleansing of the interior of thestylet 10 and of the interior of the cannula 16, a cleaning wire 25 isemployed, and is inserted inwardly through the head 13, shank 12 andstylet 10, as shown in Figs. 1 and 2 to close the passage through theinstrument, and prevent the settling of dust, or the like in theopenings thereof. lf, during the use of the device, when the rod 25 isremoved, the passages become clogged, it is only necessary to detach theflexible tube 14 from the head 13, and insert the rod 25 to forciblyeject any solid matter or gummy substance which tends to clog up thepassages through the instrument. The rod 25 is provided upon its outerend with a finger loop 26, which is relatively small, and of a size torest snugly against the outer end of the head 13, when the instrument isnot in use.

In using the instrument, the parts are stylet, andl adjusted into theposition shown in Figs. 2 and 7, with the exception that the rod 25 iswithdrawn, so as to clear the passages through the instrument, and toremove the inner projecting end of the rod 25 to leave clear thepiercing point 11. Normally, the rod 25 projects below the point 11, soas lo ward oli contact of the point 11 with surrounding objects when theinstrument is not in use. When the parts are thus adjust ed, the lowerend 17 of the cannula is raised above the point 11, and in the positionshown in Fig. 7. The instrument is now grasped by the head 13, andforced against the wall of the internal part until the stylet 10 is inposition. During this time, the cannula is locked in retracted positionhy engagement of the pin 19 in the outer slot 21, as is clearly shown inFig. 1 of the drawings. The sleeve 18 is partially rotated to bring thepin 19 into the longitiulinal slot 20, and the sleeve 18 is now forcedinwardly into the position shown in Figs. 3 and 4. This movement of thesleeve forces the cannula inwardly over the piercing point 11, andthrough the wall of the internal part, so that the lower end 17 of thecannula projects beyond the piercing point, and prevents contact thereofwith the inner walls of the internal part. lt also prevents furtherprojection of the instrument into the internal p'arts. When in thisposition, the internal part may be readily drained by the passage oflluid outwardly through the cannula and the stylet, the fluid passingout through the head 13. The flexible tubing 1-l may he placed on thehead so as to carry the fluid to any suitable draining receptacle. I tis also observed that when the instrument is in this position. fluid maybe injected into the internal part by forcing the fluid inwardly throughthe liexible tube 14.

The inner or lower end o f the cannula 16 is provided with one or moreopenings 27, which are preferably arranged in its opposite sides and inoffset relation` as shown in the drawings, the openings 27 being adaptedto receive therethrough the lluid which passes outwardly through theinstrument, or which is injected inwardly through the instrument to theinternal part. ln case the outer end of the cannula 16 is closed bycontact with an internal part or wall, the openings 27 then form themeans of connnunieation between the internal part and the instrument.

The instrument thus provides a means for piercing the wall of theinternal part. and then a means for protecting the internal part fromfurther puncturing. scraping, or other injury, by covering up thepiercing point, the entire structure in no wise affecting the drainageor injection of fluid from or into the internal part. The instrument iscompact, may be kept in a clean and sanitary 'in-aegee condition byvirtue of the easy separation and adjustment of the parts, and aninstrument which is easily handled and adjusted, when in use.

lt Will be noted from Figs. 1, 3 and 6 of the drawings, that the innerslot 21 in the adjustable sleeve 18 is slightly inclined inwardly andcircumferentially, so that as the sleeve 18 is turned to bind the stud19 in the slot 21, the sleeve 18 is moved outwardly against the shoulder15 and bound upon the shank l2, so. as to prevent rattling or any looseconnection in the instrument.

' lt is, of course. understood that various changes or modiications of aminor nature may be made in the construction and assemblage of the partsof this instrument, without departing from the spirit of the invention.and being restricted only by the scope of the following claims.

lWhat is claimed is:

1. A. paraeentesis needle and trocar comprising 'a tubular stylet havinga piercing terminal point. and a cannula snugly telescoped upon thestylet for sliding movement and having a perforated end adapted to beadvanced over said piercing point subsequent to its insertion.

2. A. paracentesis needle and troear com'- prising a tubular stylethaving a piercing point. a cannula slidable on the stylet, and having aninner end adapted to be advanced over said piercing point after itsinsertion into an internal part, and means for locking the cannula onthe stylet in retracted and in advanced positions.

3. A paracentesis needle and trocar comprising a tubular stylet having apiercing point at one end and a nipple head at its opposite end torattachment to a ilenible tube, a cannula slidable on the stylet, andhaving a beveled inner end adapted for advancement over said piercingpoint, subsequent to its insertion, and means for locking the cannula onthe stylet in retracted and in advanced positions.

l. A paracentesis needle and troear comprising a tubular stylet havinga'piercing point at one end, and a nipple head at its opposite end,'acannula slidable on the stylet and having a sleeve upon its inner end,and

slidalole Jfor advancing and retracting the in- ..v. 1f--f" a.,

ner end of the cannula `with respect to said piercing point subsequentto the insertion ot the latter.-

5. An instrument as specified, comprising an inner tubular member havinga piercing point upon its inner end, an outer tubular member slidable onsaid inner tubular member, and having a beveled inner end, a shanklcarried upon the outer end of the inner tube and having a laterallyprojecting stud at one side, and a sleeve carried upon the outer tubularmember for slidable engagement over the shank, and having a longitudinalslot therein for the reception ol1 the stud to admit the longitudinalmovement of the outer tube and sleeve, said sleeve havingcircumferential slots at the ends oit said longi' tudinal slot for thereception of saidstud to lock the sleeve in its retracted and advancedpositions.

6. An instrument as specified, comprising an inner tubular member havinga piercing inner end, a sha-nk upon its outer end, and a head upon theouter end of the shank adapted for attachment to a iiexible tube, anouter tubular member slidable on the inner member and having a sleeveupon its outer end for slidable engagement overthe shank and having anoutturned flange upon the outer end ot' the sleeve adapted to abutagainst said head to limit the outward vsliding movement of the sleeveand outer tubular mem ber, said sleeve having a longitudinal slottherein and having circumferential slots leading from the opposite endsot said longitudinal slot. said flange having a notch communicating withthe slot adjacent thereto.l said shank having an outstanding stud forengagementfn the longitudinal slot to admit the longitudinalslidingmovement of the sleeve over the shank and adapted to enter thecircumferential slots to lock the sleeve from longitudinal movement ineither of its adjusted positions.

ln testimony, that l claim the foregoing as4 my ovvn, l have heretoaflixed my signature in the presence of two Witnesses.

Dn. H Pltlllilll Pillai'.

Wlitnesses:

N. T. Pancosn, W. C. Quiberon.

liti

